Steerable medical device having a control member holding mechanism

ABSTRACT

Embodiments of the present disclosure include a medical device. The medical device may include an elongate member, a first control member and a second control member each coupled to a distal end of the elongate member, an actuator coupled to the first control member and the second control member and configured to selectively move the first control member and the second control member to steer the elongate member, and a holding mechanism deflecting a path of the first control member from the actuator to the distal end of the elongate member and a path of the second control member from the actuator to the distal end of the elongate member. The holding mechanism may be configured to apply tension on one of the first control member and the second control member as the other is moved to steer the elongate member.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of priority from U.S. ProvisionalApplication No. 61/779,405, filed on Mar. 13, 2013, the entirety ofwhich is incorporated by reference herein.

FIELD OF THE DISCLOSURE

Embodiments of the present disclosure include medical devices, and moreparticularly, medical devices including a holding mechanism for applyingtension to control members, and related methods of using such medicaldevices.

BACKGROUND OF THE DISCLOSURE

Generally, steerable medical devices, such as certain endoscopes,ureteroscopes, and other scopes, catheters, and guides, may include aflexible shaft configured to be deflected or maneuvered to facilitateguidance through tortuous or furcated anatomical passageways. In orderto effect and control the steering of the shaft, a plurality of controlcables or wires may run the length of the medical device and may beoperably connected to a distal end of the shaft. The proximal ends ofthe control cables may be coupled to a suitable actuator, and theactuator may proximally retract a control cable to bend the shaft in adesired direction.

As one control cable is proximally retracted, an opposing control cableis released or slackened. The slacked control cable may, however, beprone to uncontrollable movement within the medical device, andparticularly, within the shaft. Such movement may cause inadvertentcontact with other components of the medical device and/or snagging ofthe control cable, which may ultimately result in damage to the controlcables and/or the other components.

Accordingly, the medical device and related methods of the presentdisclosure are directed to improvements in the existing technology.Summary of the Disclosure

In accordance with an embodiment, a medical device may include anelongate member, a first control member and a second control member eachcoupled to a distal end of the elongate member, an actuator coupled tothe first control member and the second control member and configured toselectively move the first control member and the second control memberto steer the elongate member, and a holding mechanism deflecting a pathof the first control member from the actuator to the distal end of theelongate member and a path of the second control member from theactuator to the distal end of the elongate member, wherein the holdingmechanism is configured to apply tension on one of the first controlmember and the second control member as the other is moved to steer theelongate member.

Various embodiments of the disclosure may include one or more of thefollowing aspects: the holding mechanism may include a first arm and asecond arm, wherein the first arm may deflect the path of the firstcontrol member, and the second arm may deflect the path of the secondcontrol member; the first arm may include a first hooked segment, andthe second arm may include a second hooked segment, wherein the firstcontrol member may extend through the first hooked segment, and thesecond control member may extend through the second hooked segment; theholding mechanism may include a connecting segment, wherein the firstarm and the second arm may be angled towards the connecting segment suchthat the first hooked segment and the second hooked segment may face theconnecting segment; a handle coupled to the elongate member, wherein thehandle may house the first control member, the second control member,and the holding mechanism; the holding mechanism may be affixed to aninner surface of the handle; the first arm may be configured to bendwhen the first control member is moved to steer the elongate member, andthe second arm may be configured to bend when the second control memberis moved to steer the elongate member; when the first control member ismoved to steer the elongate member, the first arm may be configured tobend towards a longitudinal axis of the elongate member, and wherein,when the second control member is moved to steer the elongate member,the second arm may be configured to bend towards the longitudinal axisof the elongate member; the first arm may be longer than a length of thesecond arm; and the holding mechanism may comprise a resilient material.

In accordance with another embodiment, a medical device may include anelongate member including a longitudinal axis, a first control memberand a second control member each coupled to a distal end of the elongatemember, an actuator coupled to the first control member and the secondcontrol member and configured to selectively move the first controlmember and the second control member to steer the elongate member, and aholding mechanism including a first arm and a second arm, wherein thefirst arm is configured to apply tension on the first control member,and the second arm is configured to apply tension on the second controlmember, wherein, when the actuator moves the first control member tosteer the elongate member, the first arm is configured to bend towardsthe longitudinal axis of the elongate member.

Various embodiments of the disclosure may include one or more of thefollowing aspects: when the actuator moves the second control member tosteer the elongate member, the second arm may be configured to bendtowards the longitudinal axis of the elongate member; the actuator maybe configured to proximally retract the first control member anddistally advance the second control member to steer the elongate memberin a first direction; the actuator may be configured to proximallyretract the second control member and distally advance the first controlmember to steer the elongate member in a second direction; proximalretraction of the first control member may cause the first arm to bendtowards the longitudinal axis of the elongate member, and whereinproximal retraction of the second control member may cause the secondarm to bend towards the longitudinal axis of the elongate member; andthe first arm may include a first hooked segment through which the firstcontrol member extends, and wherein the second arm may include a secondhooked segment through which the second control member extends.

In accordance with yet another embodiment, a medical device may includean elongate member, a first control member and a second control membereach coupled to a distal end of the elongate member, an actuator coupledto the first control member and the second control member and configuredto selectively move the first control member and the second controlmember to steer the elongate member, and a holding mechanism including afirst arm configured to apply tension on the first control member andhaving a first hooked segment, and a second arm configured to applytension on the second control member and having a second hooked segment,wherein the first control member extends through the first hookedsegment, and the second control member extends through the second hookedsegment.

Various embodiments of the disclosure may include one or more of thefollowing aspects: when the actuator moves the first control member tosteer the elongate member, the first control member may be configured toapply a force on the member, the second control member may be configuredto apply a force on the second hooked segment to bend the second armtowards the longitudinal axis of the elongate member; and the first armmay be configured to apply tension to the first control member bydeflecting a path of the first control member, and the second arm may beconfigured to apply tension to the second control member by deflecting apath of the second control member.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a medical device, according to an exemplary disclosedembodiment;

FIG. 2 illustrates a plan view of parts of a handle assembly of themedical device of FIG. 1 in a linear configuration, according to anexemplary disclosed embodiment;

FIG. 3 illustrates a perspective view of a control member holdingmechanism of the medical device of FIG. 1, according to an exemplarydisclosed embodiment;

FIG. 4 illustrates a plan view of parts of a handle assembly of themedical device of FIG. 1 steered in a first direction, according to anexemplary disclosed embodiment; and

FIG. 5 illustrates a plan view of parts of a handle assembly of themedical device of FIG. 1 steered in a second direction, according to anexemplary disclosed embodiment.

DETAILED DESCRIPTION

Reference will now be made in detail to exemplary embodiments of thepresent disclosure described above and illustrated in the accompanyingdrawings. Wherever possible, the same reference numbers will be usedthroughout the drawings to refer to the same or like parts.

The terms “proximal” and “distal” are used herein to refer to therelative positions of the components of an exemplary disclosed medicaldevice. When used herein, “proximal” refers to a position relativelycloser to the exterior of the body or closer to the user of the medicaldevice. In contrast, “distal” refers to a position relatively furtheraway from the user of the medical device or closer to the interior ofthe body.

FIG. 1 illustrates a medical device 1, according to an exemplaryembodiment. Medical device 1 may be any device configured to allow anoperator to access internal body anatomies of a patient, as well asoptionally to view those anatomies and/or to deliver medicalinstruments, such as, for example, biopsy forceps, graspers, baskets,snares, probes, scissors, retrieval devices, lasers, and other tools,into the patient's body. Medical device 1 may be inserted into a varietyof body lumens and/or cavities, such as, for example, any portion of aurinary tract including a ureter, a gastrointestinal lumen including anesophagus, a vascular lumen, an airway, and the like.

For the purposes of the present disclosure, medical device 1 may be a anendoscope. Other types of devices suitable for use in connection withthe present disclosure include, as examples, a ureteroscope, ahysteroscope, a uteroscope, a bronchoscope, a cystoscope, a catheter, aguide tube, and the like.

Endoscope 1 may include a handle assembly 2 and an elongate member 3operably connected to handle assembly 2. Elongate member 3 may beconfigured to be at least partially inserted into a body of a patient.Elongate member 3 may be flexible, or may include one or more portionsthat are flexible, to allow elongate member 3 to be maneuvered andsteered within the body and traverse tortuous anatomical lumens. Forinstance, elongate member 3 may be uniformly flexible or may include aplurality of portions having varying degrees of flexibility or rigidity.Elongate member 3 may include a proximal portion 4, a distal portion 5,and a medial portion disposed between proximal portion 4 and distalportion 5.

Handle assembly 2 may include a handle housing 10 to which a steeringmechanism 11 and one or more ports 12 may be operably coupled. Port 12may provide access to one or more channels extending through elongatemember 3. For example, port 12 may provide access for one or moremedical tools to a working channel extending through elongate member 3and out a tip 9 of elongate member 3. Additionally, port 12 may provideaccess through the working channel for a suitable fluid, such as wateror gas, for, as examples, irrigation, insufflation, and/or suctionpurposes.

Steering mechanism 11 may be configured to control the steering anddeflection of distal portion 5 of elongate member 3. Steering mechanism11 may include an actuator 14 configured to control deflection of distalportion 5 between a substantially linear configuration and a curved,angled, or bent configuration. Distal portion 5 may be moved to avariety of different curved, angled, or bent configurations in a varietyof different directions relative to a longitudinal axis 16 of elongatemember 3.

Actuator 14 may include a rotatable knob or dial and may be actuated todeflect elongate member 3. For example, rotating the knobcounterclockwise or clockwise may cause distal portion 5 to deflect in afirst direction or a second direction of a first plane (i.e., up anddown relative to longitudinal axis 16). In certain other embodiments,actuator 14 may include a deflectable lever configured to be actuated upand down or side-to-side relative to handle housing 10. Actuating thedeflectable lever may cause distal portion 5 to deflect in the firstdirection or the second direction.

Although not shown, it should be appreciated that steering mechanism 11may include a second actuator configured to deflect distal portion 5 ina first direction and a second direction of a second plane differentthan the first plane (i.e., side-to-side relative to longitudinal axis16). Accordingly, steering mechanism 11 may provide four-way steering ofdistal portion 5 of elongate member 3. It should also be appreciated,however, that steering mechanism 11 may provide less or greater thanfour-way steering of distal portion 5, depending on, for example, thevolume and/or the shape of the internal body anatomies which may betraversed by elongate member 3.

FIG. 2 illustrates a plan view of inner parts of handle assembly 2 ofendoscope 1 with distal portion 5 of elongate member 3 in the linearconfiguration. Handle assembly 2 may include handle housing 10comprising two half-portions (only one half-portion shown in FIG. 2)joined together by appropriate removable fasteners, such as screws andpins, or by appropriate non-removable fastening techniques, such as heatbonding. Handle housing 10 may house steering mechanism 11. Although notshown, it should also be appreciated that handle housing 10 may houseone or more additional components of endoscope 1, including, asexamples, an illumination system and an imaging system.

Steering mechanism 11 may be housed within handle housing 10 at aproximal end 19 of handle assembly 2. As shown in FIG. 2, in addition toactuator 14, steering mechanism 11 may include a first control member35, a second control member 36, and a control member holding mechanism39. Control members 35, 36 may each be coupled to elongate member 3 ator near tip 9 and may extend through elongate member 3 and handlehousing 10 to actuator 14. Control members 35, 36 may be coupled toelongate member 3 on opposite sides of elongate member 3. It should beappreciated that control members 35, 36 may include any suitablecoupling device, such as, for example, a wire, a cable, a rod, afilament, a braided member, or a hollow tube.

The proximal ends of control members 35, 36 may be connected to a spool40 of actuator 14. In some embodiments, the proximal ends of controlmembers 35, 36 may be connected on opposite sides of the circumferenceof spool 40 and spaced apart along the length of spool 40. In certainother embodiments, control members 35, 36 may be looped one or moretimes around the circumference of spool 40. Spool 40 in turn may beconnected to the rotatable knob of actuator 14. Accordingly, rotatingthe knob counterclockwise may proximally retract control member 36 anddistally advance control member 35, thus causing distal portion 5 ofelongate member 3 to deflect in the first direction. Rotating the knobclockwise may proximally retract control member 35 and distally advancecontrol member 36, thus causing distal portion 5 to deflect in thesecond direction.

Control member holding mechanism 39 may be positioned proximate actuator14. Holding mechanism 39 may include a first arm 50 and a second arm 51.First arm 50 may include a first hooked segment 52 configured to supportcontrol member 35, and second arm 51 may include a second hooked segment53 configured to support control member 36. As will be described in moredetail below, holding mechanism 39 may be configured to retain and applytension to control members 35, 36.

FIG. 3 illustrates a perspective view of holding mechanism 39 withoutendoscope 1. Holding mechanism 39 may be a unitary piece of any suitableresilient material, such as, for example, nitinol or stainless steel. Ina normal configuration, one or both of first arm 50 and second arm 51may be in its naturally biased state (i.e., in the positions shown inFIG. 3). That is, when first arm 50 or second arm 51 is in the normalconfiguration, no force is applied on first arm 50 or second arm 51sufficient to bend first arm 50 or second arm 51.

First arm 50 and second arm 51 may be configured, however, to deflectfrom the normal configuration if a force sufficient to overcome thebiasing force of either first arm 50 or second arm 51 is applied onfirst arm 50 or second arm 51. For example, proximal retraction ofcontrol member 35 may apply sufficient force onto first arm 50 to bendfirst arm 50 downwards, as indicated by arrow A. Similarly, proximalretraction of control member 36 may apply sufficient force onto secondarm 51 to bend second arm 51 downwards, as indicated by arrow B. Distaladvancement of control member 35 may release the force on first arm 50,and the biasing force of first arm 50 may resiliently deflect first arm50 upwards back to the normal configuration, as indicated by arrow C.Likewise, distal advancement of control member 36 may release the forceon second arm 51, and the biasing force of second arm 51 may resilientlydeflect second arm 51 upwards back to the normal configuration, asindicated by arrow D.

As shown in FIG. 3, holding mechanism 39 may include a connectingsegment 60 from which first arm 50 and second arm 51 extend. Connectingsegment 60 may be connected to an inner wall of handle housing 10 by anysuitable means, such as, for example, adhesives, welding, or mechanicalfasteners. First arm 50 may extend from connecting segment 60 and mayinclude a first curved portion 61 to direct first hooked segment 52towards connecting segment 60. That is, first arm 50 may be angledtowards connecting segment 60. In addition, first arm 50 may bend atfirst curved portion 61 upon proximal retraction of control member 35.Similarly, second arm 51 may extend from connecting segment 60 and mayinclude a second curved portion 62 to direct second hooked segment 53towards connecting segment 60. Second arm 51 may be angled towardsconnecting segment 60, and may bend at second curved portion 62 uponproximal retraction of control member 36.

Moreover, first arm 50 may include a length larger than a length ofsecond arm 51. First hooked segment 52 may therefore be positionedbetween second hooked segment 53 and second curved portion 62, andsecond hooked segment 53 may be positioned between first hooked segment52 and first curved portion 61. Accordingly, first hooked segment 52 andsecond hooked segment 53 may be prevented from contacting andinterfering with each other as either of first arm 50 or second arm 51is deflected.

First arm 50 and second arm 51 may also be configured to provide spacebetween control member 35 and control member 36. For example, and asshown in FIGS. 2-5, second arm 51 may angle away from first arm 50 atsecond curved portion 62. For example, second arm 51 may be directed outof the plane of the page in FIGS. 2-5. As such, first hooked segment 52and second hooked segment 53 may be spaced apart, and consequently,control members 35, 36 extending though first and second hooked segments52, 53 may also be spaced apart. Therefore, contact and interferencebetween control members 35, 36 during actuation of actuator 14 may beprevented.

With reference back to FIG. 2, holding mechanism 39 may be positionedwithin handle housing 10 such that first and second hooked segments 52,53 may be offset from longitudinal axis 16 of elongate member 3. Forexample, holding mechanism 39 may be disposed above elongate member 3(and longitudinal axis 16) and proximate port 12. As alluded to above,control member 35 may extend through first hooked segment 52, and firstarm 50 may apply tension to control member 35 by raising a portion ofcontrol member 35 above longitudinal axis 16 of elongate member 3 andthe connection point of control member 35 at distal portion 5.Similarly, control member 36 may extend through second hooked segment53, and second arm 51 may apply tension to control member 36 by raisinga portion of control member 36 above longitudinal axis 16 of elongatemember 3 and the connection point of control member 36 at distal portion5. Therefore, first and second arms 50, 51 of holding mechanism 39 mayremove slack on control members 35, 36 by deflecting the paths ofcontrol members 35, 36 between actuator 14 and distal portion 5 ofelongate member 3.

In accordance with a first embodiment, when distal portion 5 of elongatemember 3 is in the linear (unbent) configuration, holding mechanism 39may apply tension to control members 35, 36 while first arm 50 andsecond arm 51 are in the normal configuration. First arm 50 may raise aportion of control member 35 above longitudinal axis 16 to apply tensionto control member 35, but control member 35 may not apply a force ontofirst arm 50 sufficient to overcome the biasing force of first arm 50and deflect first arm 50 downwards. In addition, second arm 51 may raisea portion of control member 36 above longitudinal axis 16 to applytension to control member 36, but control member 36 may not apply aforce onto second arm 51 sufficient to overcome the biasing force ofsecond arm 51 and deflect second arm 51 downwards.

In accordance with a second embodiment, when distal portion 5 ofelongate member 3 is in the linear (unbent) configuration, holdingmechanism 39 may apply tension to control members 35, 36 while first arm50 and second arm 51 are partially deflected from the normalconfiguration. In such an embodiment, first arm 50 may raise a portionof control member 35 above longitudinal axis 16 to apply tension tocontrol member 35. The tension on control member 35, however, may applya force onto first arm 50 sufficient to partially overcome the biasingforce of first arm 50 and slightly bend first arm 50 towardslongitudinal axis 16. Similarly, second arm 51 may raise a portion ofcontrol member 36 above longitudinal axis 16 to apply tension to controlmember 36. The tension on control member 36, however, may apply a forceonto second arm 51 sufficient to partially overcome the biasing force ofsecond arm 51and slightly bend second arm 51 towards longitudinal axis16. First arm 50 and second arm 51 may be partially deflected from thenormal configuration in the second embodiment due to a higher degree offorce applied onto first arm 50 and second arm 51 by control members 35,36 relative to the first embodiment. Such a higher degree of force maybe caused by, for example, a higher position of holding mechanism 39relative to longitudinal axis 16 and/or shorter lengths of controlmembers 35, 36 (and consequently, less pre-existing slack on controlmembers 35, 36).

FIG. 4 illustrates a plan view of inner parts of handle assembly 2 whendistal portion 5 of elongate member 3 is deflected in the firstdirection. Rotating the knob of actuator 14 counterclockwise mayproximally retract control member 36 and distally advance control member35, thus causing elongate member 3 to deflect in the first direction(i.e., up relative to longitudinal axis 16). Moreover, as control member36 is proximally retracted, control member 36 may apply a force ontosecond hooked segment 53, which may cause second arm 51 to bend. Theproximal retraction of control member 36 may deflect second hookedsegment 53 downward towards longitudinal axis 16 of elongate member 3,which may pull second arm 51 downward towards longitudinal axis 16 ofelongate member 3. Although not illustrated, it should be appreciatedthat in certain embodiments, second hooked segment 53 may be curved suchthat an apex of second hooked segment 53 substantially points towardsactuator 14 in the normal configuration. Accordingly, second hookedsegment 53 may be substantially directed towards the direction of forceapplied onto control member 36, thus facilitating eased bending ofsecond arm 51.

In accordance with the first embodiment, first arm 50 may remain in thenormal configuration when distal portion 5 of elongate member 3 issteered to the first direction. While second arm 51 is deflected uponproximal retraction of control member 36, first arm 50 may remainsubstantially stationary and may not significantly deflect or bend fromthe normal configuration. Rotating the knob counterclockwise maydistally advance control member 35 through first hooked segment 52.Distal advancement of control member 35 may not, however, apply a forceonto first hooked segment 52 sufficient to bend first arm 50, since someslack may occur in control member 35. Control member 35 may be pushedthrough first hooked segment 52 without pulling down on first arm 50.

By remaining in the normal configuration, first arm 50 may maintain sometension along control member 35 as control member 36 is proximallyretracted. Because first arm 50 may remain in the normal configuration,the path of control member 35 may be maintained above longitudinal axis16 of elongate member 3, and control member 35 may be held substantiallytaut against first hooked segment 52. When desired, elongate member 3may be steered back to the linear configuration shown in FIG. 2 byrotating the knob clockwise.

In accordance with the second embodiment, first arm 50 may resilientlydeflect towards the normal configuration when distal portion 5 ofelongate member 3 is steered to the first direction. Rotating the knobcounterclockwise may proximally retract control member 36 and distallyadvance control member 35 through first hooked segment 52. Proximalretraction of control member 36 may further deflect second arm 51downward towards longitudinal axis 16, while distal advancement ofcontrol member 35 may release some of the force applied on first arm 50by control member 35. The slight release in force may cause first arm 50to resiliently deflect back towards the normal configuration. It shouldbe appreciated that first arm 50 may deflect to the normal configurationor any position between the normal configuration and the slightly bentconfiguration discussed above.

While first arm 50 may deflect towards the normal configuration, firstarm 50 may retain the path of control member 35 above longitudinal axis16 of elongate member 3 such that tension along control member 35 may bemaintained. Moreover, control member 35 may be held substantially tautagainst first hooked segment 52.

FIG. 5 illustrates a plan view of inner parts of handle assembly 2 whendistal portion 5 of elongate member 3 is deflected in the seconddirection. Rotating the knob of actuator 14 clockwise may proximallyretract control member 35 and distally advance control member 36, thuscausing elongate member 3 to deflect in the second direction (i.e., downrelative to longitudinal axis 16). As control member 35 is proximallyretracted, control member 35 may apply a force onto first hooked segment52, which may cause first arm 50 to bend. Control member 35 may bedeflected downward towards longitudinal axis 16 of elongate member 3,which may pull first arm 50 downward towards longitudinal axis 16 ofelongate member 3. Although not illustrated, it should be appreciatedthat in certain embodiments, an apex of first hooked segment 52 maysubstantially point towards actuator 14 in the normal configuration tofacilitate eased bending of first arm 50.

In accordance with the first embodiment, second arm 51 may remain in thenormal configuration when distal portion 5 of elongate member 3 issteered to the second direction. While first arm 50 is deflected byproximal retraction of control member 35, second arm 51 may remainsubstantially stationary and may not significantly deflect or bend fromthe normal configuration. Rotating the knob clockwise may also distallyadvance control member 36 through second hooked segment 53. Distaladvancement of control member 36 may not, however, apply a force ontosecond hooked segment 53 sufficient to bend or deflect second arm 51,since some slack may occur in control member 36. Control member 36 maybe pushed through second hooked segment 53 without pulling down onsecond arm 51.

Moreover, second arm 51 may maintain some tension along control member36 as control member 35 is proximally retracted. Because second arm 51may remain in the normal configuration, the path of control member 36may be maintained above longitudinal axis 16 of elongate member 3, andcontrol member 36 may be held substantially taut against second hookedsegment 53. When desired, elongate member 3 may be deflected back to thelinear configuration shown in FIG. 2 by rotating the knobcounterclockwise.

In accordance with the second embodiment, second arm 51 may resilientlydeflect towards the normal configuration when distal portion 5 ofelongate member 3 is steered to the second direction. Rotating the knobclockwise may proximally retract control member 35 and distally advancecontrol member 36 through second hooked segment 53. Proximal retractionof control member 35 may further deflect first arm 50 downward towardslongitudinal axis 16, while distal advancement of control member 36 mayrelease some of the force applied on second arm 51 by control member 36.The slight release in force may cause second arm 51 to resilientlydeflect back towards the normal configuration. It should be appreciatedthat second arm 51 may deflect to the normal configuration or anyposition between the normal configuration and the slightly bentconfiguration discussed above.

While second arm 51 may deflect towards the normal configuration, secondarm 51 may retain the path of control member 36 above longitudinal axis16 of elongate member 3 such that tension along control member 36 may bemaintained. Moreover, control member 36 may be held substantially tautagainst second hooked segment 53.

It should be appreciated that first and second arms 50, 51 may beincrementally bent as elongate member 3 is incrementally deflected fromthe linear configuration. For example, as the knob of actuator 14 isgradually turned counterclockwise, second arm 51 may gradually bendtowards longitudinal axis 16 of elongate member 3, and distal portion 5of elongate member 3 may be gradually steered towards the firstdirection. Likewise, as the knob of actuator 14 is gradually turnedclockwise, first arm 50 may gradually bend towards longitudinal axis 16of elongate member 3, and distal portion 5 of elongate member 3 may begradually steered towards the second direction. In certain embodiments,actuator 14 may also include a suitable lock system configured to lockelongate member 3 in a desired linear or deflected position. The locksystem may include, for example, a suitable mechanism configured toprevent rotation of the knob, and in turn, lock the linear or deflectedposition of elongate member 3.

Although not illustrated, it should be appreciated that endoscope 1 mayinclude one or more additional control member holding mechanisms toretain and apply tension to any additional control members. For example,another holding mechanism may be connected to handle housing 10 oppositeholding mechanism 39 show in FIGS. 2, 4, and 5, and may retain controlmembers configured to deflect elongate member 3 side-to-side relative tolongitudinal axis 16.

It should also be appreciated that in certain embodiments, first andsecond hooked segments 52, 53 may include a coating of a suitablematerial configured to reduce friction between first and second hookedsegments 52, 53 and control members 35, 36. For example, first andsecond hooked segments 52, 53 may be coated with a lubricious material,such as, for example, polytetrafluoroethylene, to reduce friction andwear as control members 35, 36 are proximally retracted and distallyadvanced over first and second hooked segments 52, 53.

Holding mechanism 39 may provide a number of features. For example,first and second arms 50, 51 may maintain tension across control members35, 36 as either of control member 35 or control member 36 is proximallyretracted to steer elongate member 3. By maintaining tension acrosscontrol members 35, 36, holding mechanism 39 may prevent control members35, 36 from becoming slacked, thus restricting uncontrolled movementwithin handle housing 10 and/or elongate member 3. As such, damage tocontrol members 35, 36 and/or other components within endoscope 1 causedby, for example, inadvertent contact and/or snagging of control members35, 36, may be avoided.

Any aspect set forth in any embodiment may be used with any otherembodiment set forth herein. Every device and apparatus set forth hereinmay be used in any suitable medical procedure, may be advanced throughany suitable body lumen and body cavity, and may be used to accesstissue from any suitable body portion. For example, the apparatuses andmethods described herein may be used through any natural body lumen ortract, including those accessed orally, vaginally, rectally, nasally,urethrally, or through incisions in any suitable tissue.

It will be apparent to those skilled in the art that variousmodifications and variations can be made in the disclosed devices andprocesses without departing from the scope of the disclosure. Otherembodiments of the disclosure will be apparent to those skilled in theart from consideration of the specification and practice of thedisclosure disclosed herein. It is intended that the specification andexamples be considered as exemplary only.

What is claimed is:
 1. A medical device, comprising: an elongate member;a first control member and a second control member each coupled to adistal end of the elongate member; an actuator coupled to the firstcontrol member and the second control member and configured toselectively move the first control member and the second control memberto steer the elongate member; and a holding mechanism deflecting a pathof the first control member from the actuator to the distal end of theelongate member and a path of the second control member from theactuator to the distal end of the elongate member, wherein the holdingmechanism is configured to apply tension on one of the first controlmember and the second control member as the other is moved to steer theelongate member.
 2. The medical device of claim 1, wherein the holdingmechanism includes a first arm and a second arm, wherein the first armdeflects the path of the first control member, and the second armdeflects the path of the second control member.
 3. The medical device ofclaim 2, wherein the first arm includes a first hooked segment, and thesecond arm includes a second hooked segment, wherein the first controlmember extends through the first hooked segment, and the second controlmember extends through the second hooked segment.
 4. The medical deviceof claim 3, wherein the holding mechanism includes a connecting segment,wherein the first arm and the second arm are angled towards theconnecting segment such that the first hooked segment and the-secondhooked segment face the connecting segment.
 5. The medical device ofclaim 1, further comprising a handle coupled to the elongate member,wherein the handle houses the first control member, the second controlmember, and the holding mechanism.
 6. The medical device of claim 5,wherein the holding mechanism is affixed to an inner surface of thehandle.
 7. The medical device of claim 2, wherein the first arm isconfigured to bend when the first control member is moved to steer theelongate member, and the second arm is configured to bend when thesecond control member is moved to steer the elongate member.
 8. Themedical device of claim 7, wherein, when the first control member ismoved to steer the elongate member, the first arm is configured to bendtowards a longitudinal axis of the elongate member, and wherein, whenthe second control member is moved to steer the elongate member, thesecond arm is configured to bend towards the longitudinal axis of theelongate member.
 9. The medical device of claim 2, wherein the first armis longer than a length of the second arm.
 10. The medical device ofclaim 1, wherein the holding mechanism comprises a resilient material.11. A medical device, comprising: an elongate member including alongitudinal axis; a first control member and a second control membereach coupled to a distal end of the elongate member; an actuator coupledto the first control member and the second control member and configuredto selectively move the first control member and the second controlmember to steer the elongate member; and a holding mechanism including afirst arm and a second arm, wherein the first arm is configured to applytension on the first control member, and the second arm is configured toapply tension on the second control member, wherein, when the actuatormoves the first control member to steer the elongate member, the firstarm is configured to bend towards the longitudinal axis of the elongatemember.
 12. The medical device of claim 11, wherein, when the actuatormoves the second control member to steer the elongate member, the secondarm is configured to bend towards the longitudinal axis of the elongatemember.
 13. The medical device of claim 12, wherein the actuator isconfigured to proximally retract the first control member and distallyadvance the second control member to steer the elongate member in afirst direction.
 14. The medical device of claim 13, wherein theactuator is configured to proximally retract the second control memberand distally advance the first control member to steer the elongatemember in a second direction.
 15. The medical device of claim 14,wherein proximal retraction of the first control member causes the firstarm to bend towards the longitudinal axis of the elongate member, andwherein proximal retraction of the second control member causes thesecond arm to bend towards the longitudinal axis of the elongate member.16. The medical device of claim 11, wherein the first arm includes afirst hooked segment through which the first control member extends, andwherein the second arm includes a second hooked segment through whichthe second control member extends.
 17. A medical device, comprising: anelongate member; a first control member and a second control member eachcoupled to a distal end of the elongate member; an actuator coupled tothe first control member and the second control member and configured toselectively move the first control member and the second control memberto steer the elongate member; and a holding mechanism including a firstarm configured to apply tension on the first control member and having afirst hooked segment, and a second arm configured to apply tension onthe second control member and having a second hooked segment, whereinthe first control member extends through the first hooked segment, andthe second control member extends through the second hooked segment. 18.The medical device of claim 17, wherein, when the actuator moves thefirst control member to steer the elongate member, the first controlmember is configured to apply a force on the first hooked segment tobend the first arm towards a longitudinal axis of the elongate member.19. The medical device of claim 18, wherein, when the actuator moves thesecond control member to steer the elongate member, the second controlmember is configured to apply a force on the second hooked segment tobend the second arm towards the longitudinal axis of the elongatemember.
 20. The medical device of claim 17, wherein the first arm isconfigured to apply tension to the first control member by deflecting apath of the first control member, and the second arm is configured toapply tension to the second control member by deflecting a path of thesecond control member.